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With the growing success and momentum of the Affordable Care Act, it’s increasingly evident that opponents have lost the national debate. The national media are now overflowing with stories about how the right is desperately searching for a new issue to focus on during the upcoming fall elections.

Here in North Carolina, where conservative obstruction continues to hold sway for the time being — at least with respect to a federally-funded Medicaid expansion for 500,000 low-income people — we’re also seeing growing signs that the blockade is starting to crack and crumble.

The newest evidence of the occurred this week at the General Assembly where ACA opponents ran headlong into advocates for people with autism. As Adam Linker explained here the other day and Raleigh’s News & Observer explained this morning, the advocates are fighting for health insurance coverage of Autism Spectrum Disorders are running into opposition from the corporate lobbying community, which as usual, is doing everything in its power to save itself money and limit coverage.

The interesting twist is that the debate over autism coverage has served to help bottle up a conservative anti-ACA bill that would also ban new insurance mandates.

In other words, the efforts of lawmakers to pass another anti-ACA law has been revealed yet again to have an Achilles’ heel — namely, that people want health insurance. Try as they might to undermine the new law, ACA opponents cannot overcome the simple on-the-ground reality that Americans of all stripes want coverage for themselves and their families and will not — in the long run — allow politicians to deny it to them. The debate over autism coverage at the General Assembly is just the latest example of this powerful reality.

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Throughout his first campaign ad for the U.S. Senate race against Kay Hagan, Thom Tillis wears an Autism Speaks lapel pin. Autism Speaks is an important science and advocacy organization that is active nationally and in North Carolina.

One of the organization’s top legislative priorities is enacting a law that requires insurance companies to cover treatments for Autism Spectrum Disorders. In 2013 the autism community passed such a bill through the House with 105 votes in favor of the requirement and 7 against.

This will likely set up a showdown with the National Federation of Independent Business. Last month the NFIB asked the Joint Study Committee on the Affordable Care Act to pass legislation prohibiting the introduction of new insurance mandates in North Carolina for some period of time. The committee, acting with great haste, agreed to discuss this NFIB bill at a May 13 meeting. Coverage for Autism Spectrum Disorder is the only proposed insurance mandate eligible for consideration this year.

It would be jarring if Speaker Tillis touted his ties to the autism community in a campaign ad only to undermine the central policy push of Autism Speaks in his chamber. We will soon find out whether or not his commitment is bigger than a pin.

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Blue CrossWe’ve often given Blue Cross Blue Shield of North Carolina a hard time down through the years here at The Pulse, but today the insurance giant deserves credit for admitting it screwed up and taking action to correct its recent error of cancelling polices of same-sex couples.

According to BCBSNC boss Brad Wilson: “We should have more thoughtfully considered this decision, with full appreciation of the impact it would have on same-sex married couples and domestic partners. We’re sorry we failed to do so.”

Good for Wilson and BCBSNC. You can read the company’s entire statement by clicking here.

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Kevin Rogers of Action NC reminds us this morning that, in spite of the latest irresponsible Tea Party tantrum, today is a day to celebrate:

Uninsured North Carolinians Celebrate Obamacare’s Opening Day
State health insurance marketplaces start enrollment push despite government shutdown

 (Raleigh, NC) –  For the more than 1.5 million uninsured North Carolinians, today is a day to celebrate the long-awaited opening day of Healtcare.gov, the state marketplace for people to enroll in coverage under the Affordable Care Act, or Obamacare. Starting today, people who are uninsured or expect to be uninsured in 2014 can sign up for affordable, comprehensive health benefits. When these plans take effect on Jan. 1, 2014, it will fulfill a key promise of the law by outlawing decades of health insurance discrimination against millions of people with pre-existing conditions who were denied coverage or price-gouged if they could get it.

Of the nearly 1 in 5 North Carolinians who are currently uninsured, Read More

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From Guest Blogger Cathy Hope of the Georgetown Center for Children and Families.  (See her original post here.)

Whenever I read stories about the sticker shock that may hit some consumers when the Affordable Care Act takes effect, it reminds me that buying insurance can be more mystifying than buying a new car.  There have been so many jalopies being sold in “mint condition” in the wild west of the insurance market for so long that it’s going to take some time for consumers to realize how much better the insurance products will be once the ACA consumer protections take full effect.

They will finally be getting what they are paying for – coverage that will cover essential health needs and won’t disappear when they need it most.  Don’t forget, there will be other important features included in next year’s models (in other words improvements brought about by the ACA market reforms such as the elimination of pre-existing condition discrimination and gender-based rating.)

These sticker price narratives also often ignore the fact that many people won’t be paying the full sticker price because they will be eligible for federal tax credits and/or cost-sharing protections offered by the ACA to offset the cost of insurance.   A new report from the Kaiser Family Foundation found that 48% of people now buying their own insurance would be eligible for a tax credit that would offset their premium. Among the approximately half of current enrollees who will be eligible for tax credits, the average subsidy would be $5,548 per family, which would reduce their premium for the second-lowest-cost silver premium by an average of 66%.

So the next time you hear the refrain that insurance coverage will cost more under the ACA, ask yourself more expensive than what and are the premium tax credits and cost-sharing protections being taken into account?